Whipples Triad is a set of criteria which if fulfilled suggest a patient's symptoms are due to hypoglycaemia:

symptoms suggestive of hypoglycaemia

BM < or equal to 2.5

symptoms relieved by food.

Treatment

I'm sure this is all old-hat to you all... get the pt to eat if they can, 1mg IM glucagon if they can't and no IV access (remember glucagon effects only last for 20 mins and may not work at all in alcoholics) and if IV is an option the 50mls of 50% glucose or the more modern 200mls of 10% (less abrasive to the veins)

Thyroid eye disease, referred to by its friends as 'TED', can occur in people who are hyperthyroid, hypothyroid or euthyroid.

Thyrotoxicosis from any cause can cause lid lag and lid retraction.

However, only Graves disease causes:

periorbital oedema

conjunctivial injection

proptosis/exophthalmos

opthalmoplegia/diplopia

papilloedema

(as an aside, I've always been mystified by the difference between proptosis and exophthalmos. Unfortunately it appears I'm not the only one as some sources suggest the difference is related to the degree of protrusion whilst others say exophthalmos is used if the aetiology is endocrine and proptosis is used if the aetiology is not endocrine...)

In primary prevention there is no 'target' cholesterol
In secondary prevention the target is less than 4mmol/l cholesterol and less than 2mmol/l LDL

If statins are not tolerated consider:

fibrates

ezetimibe

nicotinic acid

Mechanisms of action

Statins are HMG CoA reductase inhibitors. They therefore work by decreasing the production of cholesterol in the liver. The decreased production of cholesterol in the liver also results in the liver absorbing and processing more LDL, hence further reducing cholesterol.

Grapefruit juice decreases the metabolism of statins. Patients on statins are therefore advised to avoid grapefruit juice as it would increase the risk of the rare side effect of rhabdomyolysis

Histocytosis X, aka Langerhans-cell histiocytosis, is a group of disorders in which there is organ infiltration by granulomatous lesions containing clonally proliferated dendrintic (=Langerhams) cells.

The most commonly affected organs are lungs and bones.

Lung histiocytosis tends to affect young adults and is commonest in smokers.

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About Me

UK junior doctor attempting to revise for MRCP whilst maintaining her sanity/free time for the things in life doctors know are actually luxuries, like sleeping and eating.
No responsibility taken for any inaccuracies contained within, and please be aware that as this blog will often be written in a sleep/glucose deprived state the potential for whoopsies is great.
If you want to email me with corrections/suggestions/offers of chocolate, please do so to: marietreasure7 (at) gmail.com